Due to the increasing spread of HIV and AIDS among the gay community within the US, it is important to identify key factors that predict risky sexual behavior among this subset of the population. The current study sought to examine how body image dissatisfaction (BID) among men who have sex with men (MSM) could predict engagement in the highest sexual risk behavior, unprotected receptive anal sex, mediated by the use of various substances.
Adult MSM attending the 2009 Denver Pride Fest completed self-report measures of (1) BID, including dissatisfaction with weight and overall masculinity; (2) substance use, including use of disinhibiting substances such as alcohol, marijuana, poppers, ecstasy, cocaine, methamphetamine, ketamine, rohypnol, and ghb; and (3) HIV risk behavior, specifically engagement in unprotected receptive anal sex. Participants were subdivided into two groups, those who endorsed having had unprotected receptive anal sex after drinking and those who endorsed having had unprotected receptive anal sex after using drugs , over the past 3 months.
Though the initial plan was to conduct a mediation analysis (with BID as apredictor variable, substance use as a mediator, and risky sex as an outcome variable), assumptions for mediation were not met. However, exploratory analyses illustrated some interesting findings when examining interrelationships among different variables. Therewere significant positive correlations between risky sex and use of both poppers and methamphetamine, indicating that these two drugs could be related to engagement in more risky sex. Higher muscle dissatisfaction was correlated with a decrease in illicit drug use. Though some of these findings were contrary to initial hypotheses, this studyindicates the need for further investigation of such variables in MSM, perhaps with more refined data collection techniques and possible assessment of various other interconnected variables."